Big Bench = Big Pecs + Shoulder Pain

What’s the most common injury among bodybuilders? If you like to bench press, you probably already know the answer is in your shoulder.

By Guillermo Escalante, MBA, ATC, CSCS

Take a close look at the shoulder complex and you’ll find that it’s, well, quite complex. The shoulder region consists of three major bones: the humerus (upper arm), the scapula (shoulder blade) and the clavicle (collarbone). Many bodybuilders are familiar with the shoulder joint, which is where the round head of the upper arm meets the concave structure created between the collarbone and the shoulder blade. It’s a ball-and-socket joint (like the hip) that has a very versatile range of motion. However, the shoulder girdle is not as well known to many bodybuilders. It consists of the shoulder blade and the collarbone, which are joined together by the acromioclavicular joint (AC joint) and three other ligaments. The AC joint is where the outer portion of the clavicle joins a small projection on the shoulder blade known as the acromion process. 

Injuries to the shoulder complex among bodybuilders are relatively common. A recent study published by the National Strength & Conditioning Association reported up to 36% of documented weight-training-related injuries occur in the shoulder complex. More alarming, however, is the reported 28% prevalence of an injury to the AC joint known as “weightlifter’s shoulder.” (Hint: If an injury is named after your sport, this means it occurs way too frequently.) “Weightlifter’s shoulder,” medically known as osteolysis of the distal clavicle, is characterized by widening of the AC joint, stress fracture(s) below the cartilage of the AC joint, and an erosion of the outer part of the clavicle bone. Research indicates weightlifter’s shoulder has been specifically associated with the bench-press exercise as a result of repeated microtrauma at the AC joint during the lowering phase of the exercise when the elbow drops past the trunk. 

This isn’t to say you should avoid the bench press altogether. Quite the contrary, you should incorporate it into your training program as it’s very effective at developing the chest, triceps and even shoulders. Unfortunately the bench press is definitely overused by many trainers to the point that inexperienced bodybuilders often make it their backbone exercise and do it 2-3 days per week. Additionally, the bench press is a great ego exercise. Nothing is better than loading the bar with Godzilla-like poundage and busting out a few reps in front of every pair of eyes in the gym. Like most exercises, however, you can do too much of a good thing because it can lead to unwanted injuries. The table “Benching Tips for AC Joint Health” provides some basic advice to help keep your AC joints in good health so that you build the chest and delts of a bodybuilder but aren’t one of those afflicted with weightlifter’s shoulder. 

If your AC joint is bothering you – if you’re not sure see a sports-medicine practitioner pronto – avoid performing any pressing movements for at least seven days and ice the area for 15 minutes 1-2 times per day. Over-the-counter NSAIDs might be beneficial during this rest period. When you come back to pressing movements, avoid the bench press during first 1-2 weeks back and perform your presses with about 50% of your usual weight. Every other week add a little more resistance until you’re back to pressing with no pain. If your pain persists, seek the help of a qualified medical professional such as a sports-medicine physician, certified athletic trainer or licensed physical therapist.   

Benching Tips for AC Joint Health

1. Don’t bench press every week

There are dozens of chest exercises you can choose from, so do others (e.g., dumbbell presses/flyes, machine presses, incline/decline presses, cable flyes). Unless you’re specifically trying to increase your bench press during a given time frame, do the bench press every second or third chest workout (even if training chest just once a week). 

2. Don’t always go as heavy as you can

We didn’t say to avoid going to failure, per se, but you can go to failure with lighter weight. You don’t need to pile on weights for your one-rep max every time you train (especially on the bench press).

3. Pay attention to technique

Avoid bouncing the weight at the bottom of the rep as this is where the joint gets the most stress.

4. If necessary, shorten the range of motion

If needed, roll up a towel and place it on your chest to prevent the elbows from going past the plane of your trunk and shorten the range of motion. You can also do this with safety bars in the power rack.

References:

Kolber, et al. “Shoulder Injuries Attributed to Resistance Training: A Brief Overview” Journal of Strength & Conditioning Research. 2010; 24 (6): 1696-1704 

Guillermo Escalante, MBA, ATC, CSCS, is the 2005 NPC Orange County middleweight champion and the co-owner of SportsPros Personal Training/Physical Therapy Center (www.4sportspros.com) in Claremont, CA.